Useful antiglobulin crossmatch test for DST-sensitized patients.

The AG-CDC tests were performed in parallel with C-CDC tests for studying sensitization of DST patients. Fourteen of 56 DST patients were positive by the AG-CDC tests after DST. Ten of 14 were also positive by both tests after DST. In 8 of 14 patients AG-CDC antibodies continued to be detectable even after C-CDC antibodies became undetectable as time passed and with plasmapheresis. Thus, AG-CDC tests are more sensitive compared to C-CDC tests and can extend the detection rate of DST-sensitized patients. Except for two DST patients (highly sensitized), 12 of 14 DST-sensitized patients were given transplants from specific blood donors at the time when their C-CDC tests became negative. One graft failed, another one had impaired function, and ten of them functioned. It should be noted that DST patients were transplanted successfully with or without plasmapheresis across a positive AG-CDC test if the titer was less than 1:4 at the time of transplant. All four DST recipients who developed antibodies detected only by AG-CDC tests after DST experienced severe accelerated rejections. In contrast, two of eight patients who were positive by both tests had "severe" accelerated rejections. The incidence of severe accelerated rejections was shown to be highly associated with the presence of AG-CDC antibodies. These facts suggest that AG-CDC antibodies may damage kidney grafts and result in severe accelerated rejections; and that AG-CDC tests are useful for predicting occurrence of severe accelerated rejections in DST recipients.

A case of intracranial osteochondroma (author's transl).

The authors reported a case of intracranial osteochondroma. A 52-year-old woman was admitted to Tokyo Women's Medical College hospital with seven years history of right visual disturbance and frontal heavy feeling. Neurological examination revealed merely right optic nerve impairment. A large mottled calcification in X-ray craniogram and a localized homogenous high density area illuminated by EMI scan in the right parasellar region were characteristic in diagnosis of osteochondroma. On April 21, 1976 a right fronto-temporal craniotomy was performed and the tumor tissue was removed partially. The pathological examination confirmed the diagnosis of osteochondroma (ossifying chodroma).

[Familial occurrence of pituitary adenoma (author's transl)].

The familial occurrence of brain tumors are exceedingly rare except in cases with phacomatosis. We encountered pituitary adenomas in two sisters of a family, so far presenting no evidence of multiple endocrine adenomatosis (MEA). Case 1, K. O. a 26-year-old woman was admitted to our Hospital on September 10, 1970 with visual acuity and field disturbance, irregular menstruation and acromegaly. Neurological examination: Her visual acuity was Vd 0.6 and Vs 0.3, visual field was bitemporal hemianopsia, and ther was papilledema bilaterally. She had left exophthalmos and left abducens palsy. Roentgenogram of the skull, brain scanning, cerebral angiogram, pneumoencephalogram suggested the presence of a pituitary tumor. On Sep. 17, 1970, through a left frontotemporal craniotomy the tumor was removed subtotally. The pathological diagnosis was pituitary adenoma (chromophobe). Case 2, M. T. a 31-year-old woman, sister of case 1, was admitted to the Hospital on September 19, 1973, with mild headache, left visual field disturbance and amenorrhea. She had a child, and a past history of pulmonary tbc. Neurological examination: Her visual acuity was Vd 1.2 and Vs 0.03, and visual field of the right eye was temporal lower quandrant anopsia. There was optic nerve atrophy in the left eye. Plain X-ray craniogram, brain scanning, cerebral angiogram and pheumoencephalogram suggested the presence of a pituitary tumor. On Sep. 28, 1973, a right frontal craniotomy was performed. The tumor tissue with capsule was removed subtotally. The pathological diagnosis was pituitary adenoma (mixed type). In the literatures about familial brain tumors with histological diagnosis, glioma and glioblastoma are common, meningioma is relatively rare. Pituitary adenoma with no evidence of MEA is exceedingly rare. The two sisters presented in this paper, have no evidence of hyperparathyroidism, pancreas adenoma and peptic ulcer. So, we consider, at present, these cases should not be field in MEA.

[Intracranial surgery under hemodialysis (author's transl)].

A case of pituitary adenoma operated on under hemodialysis was reported. The patient was a 43-year-old male who had been obliged to hemodialysis since April 1975 because of chronic renal failure. He was admitted in February 21, 1976 because of progressive visual symptoms. Neurological examination revealed decreased visual acuity and bitemporal hemianopsia. Radiology showed enlarged sella turcica and calcified mass in the suprasellar region. Laboratory examination disclosed severe anemia and the operation was postponed until the hematocrit improved up to 39% by blood transfusion. The operation was performed in March 17, 1976 under conventional GOF anesthesia. The tumor was covered by a calcified capsule and after nibbling off the calcified covering, the tumor was removed. Postoperative course was uneventful. Peritoneal dialysis was continued for three days immediately after operation. Urinary volume of the patient increased up to 600 ml per day after operation, probably due to the postoperative diabetes insipidus. The diabetes insipidus was rather favorable sequela in this case because the patient was released from the severe restriction of water intake.

[Clinicopathological study of supratentorial tumors with multipotential differentiation in childhood. Primitive neuroectodermal tumor].

Three cases of supratentorial tumor in childhood were studied clinico-pathologically in an attempt to clarify its histological character. Case 1: A 3-year-old boy. Carotid angiogram revealed avascular lesion in the left parietal lobe. Twice operations and radiotherapy were performed. Ten months after the second operation, he died. Surgical specimen at the first operation was composed mainly of round tumor cells. The tumor tissue contained many collagen fibers. At the periphery of this tissue, medulloblastomatous areas consisting of closely aggregated hyperchromatic small round cells were found. There were perivascular rosettes and Homer Wright rosettes. In part, tubular and papillary arrangement of cells was also present. Astrocytomatous and oligodendrogliomatous structures were also present. Surgical specimens at the second operation showed the predominance of sarcomatous areas consisting of spindle-shaped cells with abundant argyrophilic fibers. Case 2: A 10-year-old girl. CT scan revealed a heterogeneous enhanced mass with a cyst and calcification in the right parietal lobe. Operation and radiotherapy were performed. Twelve months after operation, she is still alive. Most of the surgical specimens showed sarcomatous structure with abundant argyrophilic fibers. In these tissues, there were medulloblastomatous and ependymomatous features. Papillary arrangement of cells was also present. In part, there was oligodendrogliomatous structure. Case 3: A 2-year-old girl. CT scan revealed a heterogeneous enhanced mass in the right frontal lobe. The tumor tissue was composed of an aggregation of undifferentiated small round cells with Homer Wright rosettes.(ABSTRACT TRUNCATED AT 250 WORDS)

Aromatase and estrogen 2-hydroxylase activities of human placental microsomes in pregnancy-induced hypertension.

2-Hydroxylation is one of the major metabolic pathways of estrogens and is believed to be catalyzed by a form of cytochrome P450. Recently it has been reported that estrogen 2-hydroxylase activity in human placenta is catalyzed by aromatase. Some investigators suggested the effect of catechol estrogen on human placental steroidogenesis which may be related to pregnancy-induced hypertension (PIH) through the inhibition of catechol-O-methyltransferase (COMT) activity. In order to better understand the interrelationship between placental aromatase and estrogen 2-hydroxylase activities in PIH patients, both activities were evaluated in the PIH placentas. Human placental microsomes obtained from PIH patients were incubated with [1 beta-3H]androstenedione or [2-3H]estradiol in the presence of NADPH. Aromatase and estrogen 2-hydroxylase activities were assessed by the tritium water method. The immunosuppression patterns of both activities due to monoclonal antiaromatase cytochrome P450 antibody (MAb3-2C2) were studied. Estrogen 2-hydroxylase activity was significantly higher in PIH placentas (4.7 +/- 0.9 pmol/min/mg protein, n = 7) than in normal placentas (3.0 +/- 0.7 pmol/min/mg protein, n = 7). When the PIH placental microsomes were subjected to immunosuppression by 1 to 100 micrograms IgG of MAb3-2C2, estrogen 2-hydroxylase activity was suppressed by 94 to 65% whereas aromatase activity was strongly suppressed by 72 to 17%, respectively. From our results of high estrogen 2-hydroxylase activity in PIH placentas, it is assumed that there is a different estrogen catalyzing mechanism in PIH placentas.

Role of mucus reduction and luminal acid elevation in increased susceptibility of stomach to nonsteroidal antiinflammatory drug-induced injury in arthritic rats.

We investigated the role of gastric mucus and acid secretion in the increase of nonsteroidal antiinflammatory drug-induced gastric lesions in adjuvant-induced arthritic rats. Both aspirin- and indomethacin-induced gastric injury were remarkably worsened in the arthritic rats. In the arthritic rats, the amounts of mucus glycoprotein in both the mucosa and adherent gel layer were respectively decreased to 70% and 34% of those in normal rats, while gastric acid secretion was augmented to 1.5-fold. The gastroprotective antiulcer agent ecabet sodium, which increased the mucus content in the gel layer but did not affect the luminal acid contents, prevented the increase of both lesions induced by aspirin and indomethacin. Cimetidine also inhibited the formation of aspirin- and indomethacin-induced damage as well as the acid secretion in the arthritic rats. In conclusion, an imbalance between gastric defensive and aggressive systems due to the loss of adherent mucus glycoprotein and the elevation of the luminal acid contents seems to account for the increased susceptibility of the lesion-inducing properties of nonsteroidal antiinflammatory drugs in arthritic rats.

[Two cases with the heart murmur originated from aortocoronary bypass: the diagnostic use of dipyridamole (author's transl)].

Two cases with the heart murmurs considered to be caused by aortocoronary (A-C) bypass surgery were reported. Case 1: A systolic and an early and late diastolic murmurs were noted following A-C bypass surgery. The murmurs were located at the second left intercostal space. After methoxamine, the systolic and early diastolic murmurs increases slightly in intensity, while the late diastolic murmur did not change. Amyl nitrite inhalation slightly increased the intensity of the systolic murmur, but did not that of the diastolic murmur. Dipyridamole injection at a rate of 0.142 mg/kg/min resulted in the increase of both systolic and diastolic murmurs. Case 2: A diastolic murmur was noted following the bypass surgery, which was situated over the fourth left intercostal space, 4 cm outside from the left sternal border. Methoxamine injection intensified the murmur. The murmur was not affected by amyl nitrite. After dipyridamole injection, the murmur was slightly intensified. Dipyridamole is known to dilate coronary vessels without affecting appreciably the systemic circulation. In these two cases, the murmur noted following A-C bypass surgery was increased with dipyridamole, suggesting clinical applicability of this drug in ascertaining the bypass flow murmur.

[Relationship between vascular diameter and intracardiac pressure in tricuspid or pulmonary insufficiency detected by contrast echocardiography (author's transl)].

In order to evaluate the usefulness of contrast echocardiography in the diagnosis of tricuspid (TI) and pulmonary insufficiency (PI), 30 patients with various heart diseases and 7 controls were examined. The dimensions of the inferior vena cava and pulmonary artery were also measured on the two-dimensional echocardiogram. Cardiac catheterization was performed in 18 patients to study the relationship between the diameters of the vessels and the intracardiac pressures. The following results were obtained. 1) TI was detected without difficulty by contrast method using two-dimensional echocardiography on the four-chamber view. The diagnostic sensitivity was higher than that of conventional methods. 2) PI was also detected by the parasternal approach. The regurgitation of the contrast material across the pulmonary valve was easily confirmed because of pulmonary arterial dilatation. 3) In the cases with TI, the dimension of the inferior vena cava was larger than 20 mm. The right ventricular systolic pressure and the mean right atrial pressure were higher than 40 mmHg and 6 mmHg, respectively.

2-Bromoethylamine, a suicide inhibitor of tissue-bound semicarbazide-sensitive amine oxidase.

Various mammalian tissues contain plasma membrane-bound amine oxidase, termed semicarbazide-sensitive amine oxidase (SSAO). In the present study, 2-bromoethylamine has been studied with regard to inhibitory properties towards tissue-bound SSAO in rat lung. Without preincubation, 2-bromoethylamine was a competitive and reversible SSAO inhibitor with a Ki value of 2.5 microM. After preincubation, it time-dependently and non-competitively inhibited SSAO activity, probably by forming the covalently-bound enzyme-inhibitor adduct. The data presented suggest that 2-bromoethylamine may act as a suicide inhibitor of SSAO.